| dc.contributor |
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. andrew.boulle@uct.ac.za |
|
| dc.creator |
Boulle, A |
|
| dc.creator |
Bock, P |
|
| dc.creator |
Osler, M |
|
| dc.creator |
Cohen, K |
|
| dc.creator |
Channing, L |
|
| dc.creator |
Hilderbrand, K |
|
| dc.creator |
Mothibi, E |
|
| dc.creator |
Zweigenthal, V |
|
| dc.creator |
Slingers, N |
|
| dc.creator |
Cloete, K |
|
| dc.creator |
Abdullah, F |
|
| dc.date |
2008-09 |
|
| dc.date.accessioned |
2017-01-31T07:12:26Z |
|
| dc.date.available |
2017-01-31T07:12:26Z |
|
| dc.identifier |
Antiretroviral therapy and early mortality in South Africa. 2008, 86 (9):678-87 Bull. World Health Organ. |
|
| dc.identifier |
0042-9686 |
|
| dc.identifier |
18797643 |
|
| dc.identifier |
http://hdl.handle.net/10144/38397 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/38397 |
|
| dc.identifier |
Bulletin of the World Health Organization |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/38397 |
|
| dc.description |
OBJECTIVE: To describe province-wide outcomes and temporal trends of the Western Cape Province antiretroviral treatment (ART) programme 5 years since inception, and to demonstrate the utility of the WHO monitoring system for ART. METHODS: The treatment programme started in 2001 through innovator sites. Rapid scaling-up of ART provision began early in 2004, located predominantly in primary-care facilities. Data on patients starting ART were prospectively captured into facility-based registers, from which monthly cross-sectional activity and quarterly cohort reports were aggregated. Retention in care, mortality, loss to follow-up and laboratory outcomes were calculated at 6-monthly durations on ART. FINDINGS: By the end of March 2006, 16 234 patients were in care. The cohort analysis included 12 587 adults and 1709 children. Women accounted for 70% of adults enrolled. After 4 and 3 years on ART respectively, 72.0% of adults (95% confidence interval, CI: 68.0-75.6) and 81.5% (95% CI: 75.7-86.1) of children remained in care. The percentage of adults starting ART with CD4 counts less than 50 cells/microl fell from 51.3% in 2001 to 21.5% in 2005, while mortality at 6 months fell from 12.7% to 6.6%, offset in part by an increase in loss to follow-up (reaching 4.7% at 6 months in 2005). Over 85% of adults tested had viral loads below 400 copies/ml at 6-monthly durations until 4 years on ART. CONCLUSION: The location of care in primary-care sites in this programme was associated with good retention in care, while the scaling-up of ART provision was associated with reduced early mortality. |
|
| dc.language |
en |
|
| dc.publisher |
Wolrd Health Organization |
|
| dc.rights |
Archived with thanks to Bulletin of the World Health Organization |
|
| dc.title |
Antiretroviral therapy and early mortality in South Africa. |
|